Ask Henry Marsh

Many viewers ask: How can I help Igor build his hospital? How can we help the people of the Ukraine?

Henry Marsh: I am visiting the U.S. on a fundraising lecture tour in October. Details of how donations can be made to help Igor build his hospital can be found on the film's website. I am hoping to establish a charitable fund in the USA to which donations for Igor can be made but have not yet organized this. I will make sure news about this is posted on the film's website once it is done. See the screening page on the film's website for more information.

Jamie from New York asks: Dr. Marsh says he finds it difficult to envision how electrical activity in the brain fibers he observes can constitute thought, even though it is a fact that they do. A philosopher has suggested that an understanding of how the physical activity of brain function can be responsible for our experiential world may simply be something we lack the capacity to understand. Do you agree? Does it matter if this remains in some sense mysterious, so long as neuroscience can advance in other ways?

Marsh: Philosophers who suggest that we cannot understand our own brains have been called "mysterions"! One can never predict the future -- could the Ancient Greeks have foreseen cars and electricity? Maybe in the future we will "understand how our brains work" but progress in scientific understanding, however, is based on experimentation and there are limits as to how much we can experiment on our own brains so I suspect we will never be in a position to know, or not know, whether we can "understand" how our brains work or not. Nevertheless, I find the fact that my consciousness, my feeling of "self" as I write these words, is a physical process of electro-chemistry, deeply puzzling and extraordinary. I think the main implications of all this -- deeply unpopular as it must be! -- is that life after death is unlikely and that animals think ( after a fashion) and feel as do we, although lack the power of speech, complex analysis and planning for the future. We cannot measure consciousness so we cannot know whether animals are "conscious" or not -- it seems reasonable to me to assume that they are but I doubt if we will ever know for certain.

James from Michigan asks: Mr. Marsh, Are you finding it harder for yourself to return to the Ukraine year after year after seeing the seemingly hopeless conditions? Have you witnessed any improvements in medical care for these people?

Marsh: No -- not at all. Igor's problems, and his patients' problems, make me all the more determined to continue to help him for as long as I can. I continue to go out to Ukraine on a regular basis every few months. It's in my vacation time so I cannot go as often as I would like.

Amy from Arizona asks: Dr Marsh -- Ever since I saw this, I have been dying to know your opinion about nationalized healthcare. We are having a huge debate in America about this issue, and I would love to know what your thoughts are regarding this issue. I personally am against nationalization, though I do support healthcare reform. As someone who lives, works, and deals with a nationalized system, what do you think?

Marsh: A BIG question! Most European healthcare systems are, in effect, "socialized" -- either by being funded by direct taxation or by compulsory insurance. The British NHS is not unique and has , anyway, quite a large insurance-based private healthcare sector -- about 13-14% of the population. In other words, people can choose to spend money on insurance premiums for private healthcare, without losing their entitlement to "socialized healthcare. Like most surgeons in the U.K., I work in both State and private hospitals. The American healthcare system is characterized by being absolutely wonderful at its best, incredibly expensive, and not very sympathetic or helpful to poorer people. What is more important? That rich people should get very good healthcare or that poor people should get reasonable basic healthcare? This is all complicated by lifestyle issues as well -- poor people tend to live unhealthier lives than rich people and die younger, etc. I am sure the U.S. can do better than at present but the really big problem is how to reduce healthcare costs. In the last analysis I think a "socialized" healthcare system is more humane than a purely private one, but there is no reason why one can't run the two in tandem, as happens in the U.K.

Eriko from Illinois: In your opinion, is there a higher incidence of brain tumors per capita in Ukraine compared to the rest of Europe? Do you think that the Chernobyl nuclear reactor accident or other environmental factors might have caused some of the brain tumors you have seen in Ukraine?

Marsh: Almost certainly not. Brain tumours are not caused by radiation exposure as far as we know. The epidemiological statistics for diseases in Ukraine both before and after Chernobyl are unreliable, but as far as I can tell the tumours I see in Ukraine are the same as in the West, only bigger. (Just like the fish in the cooling ponds for the now derelict reactors at Chernobyl. I am told that the fish in the ponds are living the life of Riley and are exceptionally large though presumably radioactive, and have grown enormous since they are no longer fished).